An Observational Analysis of Behavior in Depressed Preschoolers: Further Validation of Early-Onset Depression

Preschoolers’ Contribution to their Diagnosis of Depression and Anxiety: Uses and Limitations of Young Child Self-Report of Symptoms

“…Findings also demonstrated that while young children appear able to validly report on the core basic symptoms of depression based on the associations described, their reports of other more complex and/or abstract depressive symptoms appear less useful based on the absence of significant associations with parent report. Although parent report measures cannot be interpreted as the ''gold standard,'' parent report of preschool depression using age appropriate diagnostic tools has previously proven in the same study sample to be a valid indicator of a clinically significant syndrome based on numerous objective parameters including both observational and biological measures [7,43]. These findings have strongly suggested that parent reports of preschool depression are valid in general.…”

Preschool Depression

“…In keeping with this practice and based on findings that effective parental response to a child's emotion expression has been associated with a child's development of more adaptive emotion regulation and expression, observation of parent-child dyadic interactions provides a critical format for the collection of this important independent data. Along these lines, Luby and colleagues [60] found that compared with a healthy control group, depressed preschoolers displayed less enthusiasm during a structured parent-child dyadic task and had a less positive experience with their caregiver, which provided the first objective evidence of alterations in observable behavior among depressed children and additional support for the validity of preschool depression. Depressed preschoolers with anhedonia demonstrated less enthusiasm during dyadic tasks compared with other depressed preschoolers, which provided objective evidence for this key symptom.…”

Blunted stress cortisol reactivity and failure to acclimate to familiar stress in depressed and sub-syndromal children

“…PO-MDD is a psychiatric disorder characterized by DSM-IV depressive criteria (except 2-week duration criterion) that are developmentally adjusted for age appropriate manifestations in some cases that occurs during the preschool ages (i.e., under the age of 6). A growing body of empirical data provides validation for PO-MDD (Luby et al, 2003b; Luby et al, 2006; Luby et al, 2009a; Luby et al, 2009c; Dougherty et al, 2011a), and several epidemiologic studies have detected depressed preschoolers (Egger and Angold, 2006; Lavigne et al, 2009; Wichstrom et al, 2011; Bufferd et al, 2012). (Luby and colleagues 2003a, 2004) reported that depressed preschoolers at ages 3–6 showed blunted cortisol reactivity, with elevations in cortisol levels, in contrast to healthy controls who exhibited a dynamic cortisol reactivity curve.…”